The trend in U.S. health care settings toward outsourcing laundry services has resulted in significant increases in exposures to infectious disease for laundry workers. This increased vulnerability is accompanied by decreased governmental protections.

Outsourcing means workers process higher volumes of contaminated laundry. Typical On-Premise laundries handling less than a million pounds of laundry per year have given way to Industrial Laundries with total production varying from 10 to 100 million pounds per year.

UNITE HERE, the major laundry workers' union in the US and Canada, has found that with outsourcing, worker protections suffer. Exposure Control Plans, previously the responsibility of infection control officers operating under JCAHO guidelines and audits, are turned over to laundry plant managers who generally have little or no training in infection control, and for whom outside oversight is rare.

Alarmingly, public health surveillance has not progressed in response to these increasingly hazardous working conditions.

Despite the changes in oversight of the healthcare laundry process as well as in the process itself, the CDC ‘Guideline for Infection Control in Health Care Personnel' continues to restate the position that “the overall risk of disease transmission during the laundry process likely is negligible.”

Unraveling the causes of the missing data will be undertaken along with filling the above data gaps through worker interviews, international studies and other sources. Policy changes for government agencies and employers will be recommended.

Learning Objectives:1.Recognize the occupational health impact of changes in the healthcare laundry industry.
2.Identify the voices that go unheard when public health policy is based on “consensus guidance”.
3.Describe the factors that conceal the level of occupational disease in low margin industries with immigrant work forces.
4.Discuss the need for public health policy to keep pace with changes in the workplace.

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.